Saturday, July 14, 2018


           Every medical sub-specialty has certain life-threatening emergencies that doctors are trained to respond to.  Surgery is no different. Among the many urgent surgical cases we perform, there are a handful that are true life and death emergencies. Recently, I made a list for our surgical registrar (trainee) of the surgical emergencies we see and treat here at Kudjip. We have treated each and every one of them in the last two weeks, starting with one day when we saw 5 emergencies.
          Going into that operative Tuesday, our schedule held 4 elective cases. Little did we know what was about to come. Early in the morning, Dr. Ben was called for a patient with tension pneumothorax –a collapsed lung with increased pressure in the chest that compresses the heart. He quickly placed a chest tube to decompress the chest and allow the collapsed lung to re-inflate. 
          Next, during rounds, we were consulted on two emergency surgical patients. The first patient had a closed head injury from a rubgy match and was starting to show signs of right-sided paralysis. He was immediately taken to the operating theater for a craniotomy (drilling holes in the skull to release blood that was putting pressure on the brain). The second patient was a young man with tuberculosis who developed a pericardial effusion with signs of tamponade (fluid surrounding and compressing the heart). Dr. Ben performed an emergent pericardial drainage procedure on him.  Finally, we were able to start our scheduled cases—removing lumps, draining pus, and excising cancer—typical surgery day cases. Between our regularly scheduled cases, we also drained a dental abscess that had grown so large it was extending below the patient’s jaw to her neck. This type of abscess, called Ludwig’s angina, can lead to life-threatening blockage of the airway. At the end of the operative day, our fifth emergency patient arrived in the ER with a ruptured spleen after blunt trauma. That is when I sat down with our surgical registrar and made the list of the major surgical emergencies we treat. We had seen 5 of the 8 in less than 12 hours! 
             Over the course of the past week, we completed the list with several c-sections for fetal distress, a ruptured ectopic and a patient with an ischemic arm.  That man presented with a crush injury to the arm. The muscle swelling and bleeding around his fracture site cut off the circulation to his hand (compartment syndrome), so Dr. Ben performed a fasciotomy to release the swelling in his arm. 
          It has been a crazy two weeks of surgery, but praise God for his provision through it all. Please pray for all our patients as they heal from surgery and for our surgical team to get some rest after two crazy weeks of emergency surgery. 

Saturday, July 7, 2018

Birds of Paradise

Trekking to the coffee grove
         Papua New Guinea has long been a favorite destination for serious birders. This group of islands holds myriad species, including 42 different types of Bird of Paradise, which can only be found in this region of the world. Dr. Bill and Marsha McCoy, two of our long-term missionaries at Kudjip, are terrific birders and they have shared their enthusiasm (and binoculars) with many people over the years. Soon, the McCoys will retire and return to the States, but before they do, they are rising up a new generation of birders: showing us their special birding sites, introducing us to local guides, and imparting birding tips that they have gathered over the years. 
Ragianna silhouette
Ragianna close-up
Credit: Australian Geographic

         Recently, Bill took a group of us on a sunrise expedition to a village less than 20 minutes from Kudjip. After arriving at his local friend's house, we trekked a short distance into a coffee grove that is shadowed by tall pine trees. High in the trees, silhouetted against the early morning light, we saw nearly a dozen Ragianna Bird of Paradise dancing, displaying their ornate feathers, and calling to their mates. It was amazing to see so many so close together. 

Erin spotting the Superb
Bird of Paradise
Superb close-up
Credit: San Diego Zoo
 If that wasn't enough, we later found a Superb Bird of Paradise flashing his characteristic neck feathers high in a tree. Although we weren’t close enough to see the stunning blue plumage characteristic of his mating dance, we were all enthralled by this small but showy bird. No one was happier than Erin, who has heard the call of the Superb many times in her 10 years in PNG, but never actually saw one until this trip. 

Bill mentoring Matt
Bill definitely ignited a new enthusiasm for birding in this group of younger missionaries. Hopefully we can carry on his legacy for many more years to come.